NPIMap

Organization Active NPI

Lake Park Operations, LLC

  • Skilled Nursing Facility
  • Madison, FL
National Provider Identifier
1184082828
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAKE PARK OPERATIONS, LLC
Practice address
259 SW Captain Brown Rd
Madison, FL 32340-4316
Phone
(850) 973-8277
NPI assigned
Feb 9, 2016
Last updated
Mar 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Henry Steinmetz
Title
Manager
Phone
(732) 813-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

259 SW Captain Brown Rd
Madison, FL 32340-4316

Mailing address

410 Monmouth Ave Apt 201
Lakewood, NJ 08701-3747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161104000018 FL Part A Provider - Skilled Nursing Facility 6204114796 Practice locations: Madison, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184082828. Details of each certification follow.

Skilled nursing facility certification: CCN 105892

Legal name
LAKE PARK OPERATIONS, LLC
Doing business as
LAKE PARK OF MADISON NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 25, 1995
Last certification
Oct 31, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Topaz
Organization structure
LLCProprietary
Incorporated
Feb 8, 2016 in FL
Enrollment address
259 SW Captain Brown Rd
Madison, FL 32340-4316
Nursing home name
LAKE PARK OF MADISON NURSING AND REHABILITATION CE
Affiliated entity
MAXIMUS HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lake Park of Madison Nursing and Rehabilitation CeCCN 105892 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 25, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12082.9 residents per day on average
Chain
Maximus Healthcare Group7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

259 SW Captain Brown Rd
Madison, FL 32340
Phone (850) 973-8277

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Royal Rehab South Organization, Brooklyn, NY LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 38.43%
Adp of the SNF Aug 1, 2022
Maximus RRS LLC Organization, Hickory, NC LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2022 11.58%
Adp of the SNF Aug 1, 2022
Lake Park Max Holdings LLC Organization, Madison, FL LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 28, 2016 100%
Organization, Hickory, NC LLC Adp of the SNF Aug 1, 2022
Ashley Sevor Individual Operational/Managerial Control Jan 8, 2022
Adp of the SNF Nov 21, 2025
William Lantz Effinger Individual Adp of the SNF Jul 1, 2022
Organization, Hickory, NC LLC Adp of the SNF Aug 1, 2022
Organization, Hickory, NC LLC Adp of the SNF Nov 21, 2025
Nisson Hirsch Individual 5% Or Greater Indirect Ownership Interest Sep 21, 2016 10%
Adp of the SNF Aug 1, 2022
Yisroel Bornstein Individual 5% Or Greater Indirect Ownership Interest Feb 8, 2016 20%
Adp of the SNF Aug 1, 2022
LBS Capital Holdings LLC Organization, Brooklyn, NY LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2022 20%
Adp of the SNF Jun 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1184082828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MONMOUTH AVE APT 201",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 SW CAPTAIN BROWN RD",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323404316",
            "telephone_number": "850-973-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PARK OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "STEINMETZ",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-813-5000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, FL

Sources for this page

Verify at the official NPI Registry.